Objectives. The Edinburgh Cognitive and Behavioral ALS Screen (ECAS) is a brief multi-domain assessment designed for people with Amyotrophic Lateral Sclerosis (ALS). This study evaluated the clinical impact of using the ECAS on ALS patients, carers and healthcare professionals. A secondary aim was to evaluate the clinical impact of neuropsychological intervention. Methods. A survey of current screening practices in ALS services across the UK was undertaken. In addition comparative case studies, in seven ALS care contexts, was qualitatively explored through interviews with patients, carers and healthcare professionals. Results. 22/34 health care services responded to the survey. 95% screen patients for cognitive and behavioral changes and all used the ECAS. Thematic analysis indicated that the ECAS: raises awareness about cognitive and behavioral change between patients, carers and healthcare professionals; validates and/or reassures; identifies changes, aids understanding of the patients' presentation and informs clinical decision-making. The latter includes suitability of interventions, adaptations by the multidisciplinary team, discussions about end-of-life care, referral on to other services, and identifying carers' support needs. A number of indirect economic benefits were described. Clinical neuropsychological intervention was reported to help the multidisciplinary team manage the care particularly of complex cases, the effects on daily life, and stress of patients, carers and families. Conclusions. The ECAS has been widely implemented across ALS health care teams in the UK. Screening for cognitive/behavioral deficits and neuropsychological intervention has a positive impact on patients, carers and healthcare professionals and improves the quality of routine clinical care.

中文翻译：

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爱丁堡认知与行为ALS筛查（ECAS）和神经心理干预在常规ALS护理中的临床影响。

目标。爱丁堡认知和行为ALS屏幕（ECAS）是针对患有肌萎缩性侧索硬化症（ALS）的人设计的简短的多域评估。这项研究评估了使用ECAS对ALS患者，护理人员和医疗保健专业人员的临床影响。次要目的是评估神经心理学干预的临床影响。方法。对英国范围内ALS服务的当前筛查实践进行了调查。此外，通过与患者，护理人员和医疗保健专业人员的访谈，定性地探索了在七个ALS护理环境中的比较案例研究。结果。22/34的卫生保健服务对调查做出了回应。95％的患者筛查了认知和行为变化，并且全部使用了ECAS。专题分析表明，ECAS：提高对患者，护理人员和医疗保健专业人员之间认知和行为改变的认识；验证和/或保证；识别变化，帮助理解患者的表现并为临床决策提供依据。后者包括干预措施的适用性，多学科团队的适应，有关临终护理的讨论，转介其他服务以及确定护理人员的支持需求。描述了许多间接的经济利益。据报道，临床神经心理学干预可以帮助多学科团队管理护理，尤其是复杂病例的护理，对日常生活的影响以及患者，护理人员和家庭的压力。结论。ECAS已在英国的ALS卫生保健团队中广泛实施。